HomeLibraryNatalia Taubina: On the Psychiatric Evaluation of Mikhail Kosenko

Natalia Taubina: On the Psychiatric Evaluation of Mikhail Kosenko

September 25, 2012 11:17

I have in front of me a report released by a committee of forensic psychiatrists who conducted an outpatient competency evaluation of Mikhail Kosenko. The report's findings, judging by recent information in the press and the logic of the document itself, became the main reason why the court decided to institute separate proceedings against Mikhail Kosenko.

I am neither a psychiatrist nor a psychologist, and therefore I cannot give a professional opinion on the matter. Public Verdict, however, did ask for such an opinion, and appealed to the Independent Psychiatric Association of Russia -a non-governmental, non-profit organization that seeks to prevent instances of repressive psychiatry. Before long, we will know the opinion of these professionals.

But what I am is a clear-headed thinker who possesses sound reasoning skills. And the results of Kosenko's competency evaluation, produced by a committee of psychiatrists from the Serbsky State Scientific Centre for Social and Forensic Psychiatry, have thrown me into complete bewilderment.

If you'll recall, Mikhail Kosenko was detained in early June for his alleged participation in the "mass disturbances" that occurred on 6 May at Bolotnaya Square. As a measure of restraint, the court ordered him to be placed under custody. But Kosenko, as it turns out, is a registered disabled person of the second group-one of three categories used to designate disability status in present-day Russia-who suffers from a mental impairment that resulted from a concussion sustained during his time in the army. The court did not give this fact due consideration. From the day of his arrest until now, one of the main issues surrounding Kosenko's detention has been his necessary medical treatment.

Prior to his detention, Kosenko regularly took medications and met with a doctor every two weeks. During his first few days at the pre-trial detention centre, he met with a doctor only once, and the doctor appeared more concerned with his political leanings than with the state of his health. When his lawyer asked why Kosenko was not receiving medical care and inquired when a doctor would come, the officials at the detention centre said their staffing plan includes an on-site doctor, but the position is vacant. In the latter half of July, word got out that Kosenko had been examined by a specialist, and there appeared hope that he would finally get the medical assistance he needs. But the hope did not materialize. Kosenko's competency evaluation was scheduled for 23-24 July, and it was precisely for this reason that he got a visit from the Serbsky psychiatrists.

The psychiatrists had to answer a series of questions: did Kosenko suffer from a mental disorder? If yes, which one? Did he have the mental capacity to understand the charges against him? Did the current state of his health permit him to take part in investigative proceedings? Did he have the capacity to defend his rights and legal interests independently in a criminal trial? Did he have the capacity to grasp the circumstances that bear significance on his case, and to give testimonies? Did he require any mandatory medical procedures, and if so, which ones? Did his subjugation to the conditions inside the detention cell affect his health, and was there a possibility of his condition worsening, or of any other threat to his health?

The report draws particular attention to the health problems of Kosenko's father and to the events of the early 2000s, when Kosenko, who was then serving in the army, sustained an injury and was became an out-patient at the Psychoneurological Dispensary, after which he was discharged. Citing the medical files and observations on Kosenko's health from the period between 2001 and 2012, the psychiatric committee notes that "the defendant was constantly seeing a psychiatrist...no developments were observed, he remained inactive, passive, monotonous, closed off." The experts later describe their own encounter with Kosenko, reporting that the latter understood that he was undergoing evaluations, and that he correctly identified the medical centre where their meeting took place. Further in the text, the experts write (using this exact punctuation, including the quotation marks):

When asked about the acts he was charged with, the defendant denied his involvement. He said he attended the rally because he has "political convictions" and wanted to "display and voice" them in order to "be with the people." He declared that he is "an opponent of the existing regime," adding that "the regime exists solely for its own benefit," that "the individual is not protected," and that there is "no freedom." He reported that participants clashed with special-unit police at the rally and that he "accidentally" ended up in the zone of conflict, but did not hit anyone. He claimed he is a "political prisoner" whose identification and involvement in the criminal case were the result of "falsifications." He said he is "only guilty because he was caught on camera." At the same time, the defendant said he hopes for an acquittal of all charges against him and looks forward to his "rehabilitation," seeming convinced that his trial will have a positive outcome. He said he is certain that upon his release, "the perpetrators will be punished." The defendant said he has begun to "feel worse" since his arrest and confinement. He said he began doing "auto-training" at the detention centre so as not to "descend into madness."

It should be noted that earlier in the report, the experts claimed that Kosenko did not bring up any complaints about his health.

Later on-literally, in the next sentence-the experts turn to their conclusions, which sound like they belong in a completely different story:

The defendant's thought processes were scattered and inconclusive. His reasoning was frequently abnormal. His emotional responsiveness was poor. The defendant was unable to adequately assess his position in the current investigative proceedings... The committee concludes that Kosenko suffers from a chronic psychological disorder in the form of paranoid schizophrenia... During the rally, the aforementioned mental disorder made him unable to understand the true nature and the public threat presented by the acts with which he was charged... At present, due to his psychological state, Kosenko is unable to fully comprehend the nature and significance of the criminal proceedings and his own role in the process... He is unable to take part in the judicial and investigative procedures... He poses a threat to himself and to the people around him, and needs to be committed to a medical institution."

The report lacks any mention or description of the specific methods the committee members used to carry out the evaluation, which could have provided a basis for their intermittent conclusions-including their conclusions about the defendant's thought processes and reasoning. As it turns out, if you refuse to plead guilty and maintain that you ended up at the scene of conflict by chance, without hitting anyone (meanwhile, the video recording confirms merely your presence at the scene, giving no evidence of violent behavior); and if you believe that your case has been falsified and that the perpetrators of the falsification will be punished upon your release, then these are grounds to claim that your judgment is impaired and your thought process is scattered and inconclusive. You are therefore a threat to society, and require compulsory medical treatment. I point out that, to my knowledge, no such conclusion emerged during Kosenko's 12 years of independent living under the constant oversight of a psychiatrist.

I should make separate mention of the fact that the evaluation took place a month and a half after Kosenko was detained. The entire time he did not receive the medical care that he needed, whereas before his arrest he took medications on a regular basis-an issue he brought up more than once with the court psychiatrists. Detention alone is a source of stress, especially for a person with a mental disorder who is not receiving help. The state, represented by the investigators and the detention centre officials, should have gone out of its way to provide the defendant with the necessary guarantee of his rights-which includes fulfilling its obligation to give him adequate medical care. All he got instead was the response that the doctor's post is vacant, followed by an evaluation for competency.

Finally, the most important question, in my opinion-whether Kosenko's confinement at the detention centre has had an effect on his health-remains unanswered by the experts, who say that kind of judgment lies outside their scope of powers. So they have the right to stamp the defendant with the diagnosis: "Threat to society, should be committed." That is in the scope of their powers. But they don't have the power to evaluate how the conditions in the detention centre, along with the absence of necessary medical care, affect a person's health.

This is painfully similar to the evaluations that were carried out during the political trials of the 1980s. But you don't even have to go back that far to find similar cases. I'm thinking, for example, of the evaluation from the Pussy Riot trial.

For now, we will wait for the opinion of the Independent Psychiatric Association of Russia.

Natalia Taubina lives in Moscow and is director of the Public Verdict Foundation.